Determining jaw movement

ABSTRACT

Apparatuses, components, devices, methods, and systems for determining jaw movement are provided. An example patient assembly for capturing motion data of a patient includes a clutch configured to be worn by the patient on a dentition of the patient. The clutch includes a dentition coupling device configured to couple to the dentition of the patient and includes an extension member configured to protrude out from the patient&#39;s mouth. The clutch also includes a position indicating system rigidly connected to the dentition coupling device. An example position indicating system emits a plurality of light beams. Some examples also include an imaging system and a motion determining device. An example imaging system captures a plurality of image sets that each include at least one of a plurality of screens upon which the light beams project. An example motion determining device processes the captured image sets to determine the motion of the patient&#39;s dentition.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority, as appropriate, to U.S. Ser. No.62/328,837, titled “DETERMINING JAW MOVEMENT” and filed Apr. 28, 2016,the disclosure of which is hereby incorporated by reference in itsentirety.

BACKGROUND

Understanding and recording an accurate static relationship betweenteeth in a patient's upper jaw and lower jaw is an important first stepin the art and science of designing dental restorations and otherplanning dental or surgical interventions that affect dental/skeletalfunction and aesthetics of the facial musculature system.

Additionally, the dynamic motion of the lower jaw and dentitioninteracting functionally and aesthetically is even more important in thevarious reconstructive domains in dentistry and medicine that requireprecise knowledge and locations of the musculoskeletal-dental componentsthat define this motion. The greater accuracy of motion definitionallows for more precise design of restorations (e.g., crowns, implants,full/partial prosthesis) and associated macro procedures such asorthognathic surgery, trauma reconstruction, etc. These physicalcomponents can best be described in engineering terms as a kinematiclinkage system incorporating the relationship of the temporomandibularjoint to the dentition and soft tissue of the face. This linkagedefinition has only been approximated poorly by traditional articulatordevices and systems in dentistry.

Dental appliances may be used in the treatment of various dentalconditions. Examples of dental appliances include therapeutic appliancesand restorative appliances (dental restorations). Non-limiting examplesof therapeutic appliances include surgical splints, occlusal splints,orthodontic retainers, and orthodontic aligners. A dental restoration isused to restore a tooth or multiple teeth. For example, a crown is adental restoration that is used to restore a single tooth. A bridge isanother example of a dental restoration. A bridge may be used to restoreone or more teeth. A denture is another example of a dental restoration.A denture can be a full or partial denture. Dentures can also be fixedor removable. An implant is yet another example of a dental restoration.Dental implants are prosthetic devices that are placed in bone tissue ofa patient's jaw and used to secure other dental restorations such asimplant abutments and crowns, or partial and full dentures. In somecircumstances, dental restorations are used to restore functionalityafter a tooth is damaged. In other circumstances, dental restorationsare used to aesthetically improve a patient's dentition.

When complex or multiple dental appliances, dental restorations, ordental therapies are applied to a patient simultaneously, errors orinaccuracies in the representation of dental motion are compounded,resulting in inadequate or suboptimal results for patients. In the worstcase, inaccurate motion data can result in the complete failure of theappliances, restorations, or treatment at very high cost clinically,financially, and emotionally.

SUMMARY

In general terms, this disclosure is directed to a system for measuringjaw movement. In one possible configuration and by non-limiting example,a patient assembly is coupled to a patient's dentition and imagingsystem captures images of the patient assembly as the patient'sdentition moves.

One aspect is an apparatus configured to be worn on a dentition of apatient, the apparatus comprising: a dentition coupling deviceconfigured to couple to the dentition of the patient, the dentitioncoupling device including an extension member configured to protrude outfrom the patient's mouth; and a position indicating system rigidlyconnected to the dentition coupling device, the position indicatingsystem including: a housing configured to rigidly connect to theextension member of the dentition coupling device; at first lightemitter disposed within the housing and oriented to emit light in afirst direction; a second light emitter disposed within the housing andoriented to emit light in a second direction, the second direction beingcollinear with and opposite to the first direction; and a third lightemitter disposed within the housing and oriented to emit light in athird direction, the third direction that is different than the firstdirection and the second direction.

Another aspect is a patient assembly for capturing motion data of apatient comprising: a clutch configured to be worn by the patient on adentition of the patient, the clutch comprising: a dentition couplingdevice configured to couple to the dentition of the patient, thedentition coupling device including an extension member configured toprotrude out from the patient's mouth; a housing configured to rigidlyconnect to the extension member of the dentition coupling device; atfirst light emitter disposed within the housing and oriented to emitlight in a first direction; a second light emitter disposed within thehousing and oriented to emit light in a second direction, the seconddirection being collinear with and opposite to the first direction; anda third light emitter disposed within the housing and oriented to emitlight in a third direction, the third light emitter oriented such that aline corresponding to the third direction intersects a linecorresponding to the first direction.

One other aspect is A motion capture system for capturing jaw movementof a patient, the system comprising: a patient assembly configured to beworn by the patient, the patient assembly comprising a clutch configuredto be worn on an arch of the patient's dentition and a referencestructure configured to be worn on the opposite arch, the clutch beingconfigured to emit a plurality of light beams and the referencestructure being configured to emit a plurality of reference light beams;an imaging system configured to capture a plurality of image sets,wherein each image set comprises a plurality of images and each image ofthe plurality of images includes at least one of a plurality of screens;and a motion determining device configured to process image setscaptured by the imaging system to determine the motion of the patient'sdentition.

Examples are implemented as a computer process, a computing system, oras an article of manufacture such as a device, computer program product,or computer readable medium. According to an aspect, the computerprogram product is a computer storage medium readable by a computersystem and encoding a computer program comprising instructions forexecuting a computer process.

The details of one or more aspects are set forth in the accompanyingdrawings and description below. Other features and advantages will beapparent from a reading of the following detailed description and areview of the associated drawings. It is to be understood that thefollowing detailed description is explanatory only and is notrestrictive of the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic block diagram illustrating an example motioncapture system for capturing jaw movement.

FIG. 2 illustrates a block diagram of an example patient assembly ofFIG. 1.

FIG. 3 illustrates an example embodiment of the clutch of FIG. 2.

FIG. 4 illustrates an example embodiment of a dentition couplingframework of the clutch or reference structure of FIG. 2.

FIG. 5 illustrates an example impression device that is configured tomate with the dentition coupling framework of FIG. 3.

FIG. 6 illustrates an example embodiment of a dentition couplingframework of the clutch or reference structure of FIG. 3.

FIG. 7 illustrates a top view of an embodiment of the referencestructure of FIG. 2 and an embodiment of the imaging system of FIG. 1.

FIG. 8 illustrates another embodiment of the patient assembly of FIG. 1.

FIG. 9 illustrates an example of a light source assembly and anembodiment of the clutch position indicator of FIG. 2.

FIG. 10 illustrates an example of an imaging system of FIG. 1.

FIG. 11 illustrates a perspective view of part of the embodiment of thereference structure of FIG. 13 and an embodiment of the clutch of FIG.2.

FIG. 12 illustrates a perspective view of part of the embodiment of thereference structure of FIG. 13.

FIG. 13 illustrates a top view of an embodiment of the referencestructure of FIG. 2 and an embodiment of the imaging system of FIG. 1.

FIG. 14 illustrates a perspective view of part of the embodiment of thereference structure of FIG. 13 and of the imaging system of FIG. 12.

FIG. 15 is a schematic block diagram illustrating an example of a systemfor using jaw motion captured by the system of FIG. 1 to fabricate adental appliance or provide dental therapy.

FIG. 16 is an example process for designing a dental appliance ortreatment based on captured jaw motion performed by embodiments of thesystem of FIG. 1.

FIG. 17 is an example process for determining relative motion of thepatient's upper and lower dentition based on images captured by theimaging system of FIG. 1 that is performed by embodiments of the motiondetermining device of FIG. 1.

FIG. 18 illustrates an example transfer assembly usable with embodimentsof a clutch of the patient assembly of FIG. 1.

FIG. 19 illustrates a calibration plate usable with embodiments of thesystem of FIG. 1.

FIG. 20 illustrates an example embodiment of a dentition couplingframework of the clutch or reference structure of FIG. 2.

FIG. 21 illustrates an example architecture of a computing device, whichcan be used to implement aspects according to the present disclosure.

DETAILED DESCRIPTION

Various embodiments will be described in detail with reference to thedrawings, wherein like reference numerals represent like parts andassemblies throughout the several views. Reference to variousembodiments does not limit the scope of the claims attached hereto.Additionally, any examples set forth in this specification are notintended to be limiting and merely set forth some of the many possibleembodiments for the appended claims.

The present disclosure relates to a jaw movement measurement system. Forexample, the system may record the motion of a patient's mandiblerelative to the patient's maxilla. In some embodiments, the systemoperates to infer the approximate location of a screw axis correspondingto the condyloid process of the temporomandibular joint of the patient.Further, the system may generate a model of a range of motion of themandible relative to the maxilla based on the inferred location of thescrew axis, the recorded motion, or both.

In embodiments, the recorded motion is applied to a three-dimensionaldigital model of at least a portion of the patient's dentition. Thismotion can then be used while designing dental appliances or planningvarious dental therapies for the patient. In this manner, the appliancesand therapies can be designed based on analysis of a range of actualmotion for the patient. This may be especially beneficial when designingcomplex restorations such as bridges, implants, or implant-supportedprosthesis for the treatment of edentulous or partially edentulousdentitions as well as in providing dental therapies such asoral-maxillofacial reconstructive surgery.

FIG. 1 is a schematic block diagram illustrating an example motioncapture system 100 for capturing jaw movement. In this example, themotion capture system 100 includes an imaging system 102, a patientassembly 104, and a motion determining device 106. Also shown in FIG. 1are a patient and a network.

In some embodiments, the imaging system 102 is an optical sensing devicethat captures a plurality of images as the patient's jaw moves. Forexample, the imaging system 102 may comprise one or more cameras such asvideo cameras. In some embodiments, the imaging system 102 captures aplurality of images that do not necessarily include the patientassembly, but can be used to determine the position of the patientassembly 104 (e.g., the patient assembly may emit lights and someembodiments capture images of surfaces upon which those lights areprojected).

In addition to capturing the images, the imaging system 102 may captureor generate various information about the images. As an example, theimaging system 102 can generate timing information about the images.Although alternatives are possible, the timing information can include atimestamp for each of the images. Alternatively or additionally, a framerate (e.g., 10 frames/second, 24 frames/second, 60 frames/second) isstored with a group of images. Other types of information that can begenerated for the images includes an identifier of a camera, a positionof a camera, or settings used when capturing the image.

The patient assembly 104 is an assembly that is configured to be securedto the patient. The patient assembly 104 or parts thereof may be worn bythe patient and may move freely with the patient. In some embodiments,at least some portions of the patient assembly may limit the motion ofthe patient when secured thereto.

In some embodiments, the patient assembly 104 includes aspects that areconfigured to be imaged using the imaging system 102 and that can beused to determine the position of the patient assembly 104. The patientassembly 104 may include one or more fiducial markers. Alternatively oradditionally, the patient assembly 104 may include light emitters thatemit a pattern of light that projects on one or more surfaces, which canbe imaged to determine the position of the patient assembly 104.

In some embodiments, the patient assembly comprises separate componentsthat are configured to be worn on the upper dentition and the lowerdentition and to move independently of each other so that the motion ofthe lower dentition relative to the upper dentition can be determined.Examples of the patient assembly 104 are illustrated and describedthroughout, including in FIG. 2.

The motion determining device 106 determines the motion of the patientassembly 104 based on images captured by the imaging system 102. In someembodiments, the motion determining device 106 comprises a computingdevice that uses image processing techniques to determinethree-dimensional coordinates of the patient assembly 104 (or portionsof the patient assembly) as the patient's jaw is in different positions.Based on the determined three-dimensional coordinates of the patientassembly, some embodiments determine the relative positions andmovements of the patient's upper and lower dentition. Further, someembodiments infer the location of a kinematically derived screw axisthat is usable in modeling the motion of the patient's mandible(including the lower dentition) about the temporomandibular joint.Examples of the motion determining device 106 and operations it performsare illustrated and described throughout, including in FIGS. 16-17.

FIG. 2 illustrates a block diagram of an example patient assembly 104.In this example, the patient assembly comprises a clutch 120 and areference structure 122.

The clutch 120 is a device that is configured to couple to a patient'sdentition. For example, the clutch 120 may grip the teeth of thedentition of the patient. In some embodiments, the clutch 120 comprisesa dentition coupling device 124 and a position indicator system 128. Insome embodiments, the clutch 120 is configured to couple to the lowerdentition of the patient so as to move with the patient's mandible. Inother embodiments, the clutch 120 may be configured to couple to thepatient's upper dentition so as to move with the patient's maxilla.

The dentition coupling device 124 is configured to removably couple tothe patient's dentition. In some embodiments, the dentition couplingdevice 124 rigidly couples to the patient's dentition such that whilecoupled, the movement of the dentition coupling device 124 relative tothe patient's dentition is minimized. Various embodiments includevarious coupling mechanisms.

For example, some embodiments couple to the patient's dentition usingbrackets that are adhered to the patient's teeth with a dental ororthodontic adhesive. As another example, some embodiments couple to thepatient's dentition using an impression material. For example, someembodiments of the dentition coupling device 124 comprise an impressiontray and an impression material such as polyvinyl siloxane. To couplethe dentition coupling device 124 to the patient's dentition, theimpression tray is filled with impression material and then placed overthe patient's dentition. As the impression material hardens, thedentition coupling device 124 couples to the patient's dentition.

Alternatively, some embodiments comprise a dentition coupling device 124that is custom designed for a patient based on a three-dimensional modelof the patient's dentition. For example, the dentition coupling device124 may be formed using a rapid fabrication machine. One example of arapid fabrication machine is a three-dimensional printer, such as thePROJET® line of printers from 3D Systems, Inc. of Rock Hill, S.C.Another example of a rapid fabrication machine is a milling device, suchas a computer numerically controlled (CNC) milling device. In theseembodiments, the dentition coupling device 124 may comprise variousmechanical retention devices such as clasps that are configured to fitin an undercut region of the patient's dentition.

Embodiments of the dentition coupling device 124 may be operable tocouple to the patient's dentition using a combination of one or moremechanical retention structures, adhesives, and impression materials.For example, the dentition coupling device 124 may include aperturesthrough which a fastening device such as a temporary anchorage devicemay be threaded to secure the dentition coupling device 124 to thepatient's dentition. For example, the temporary anchorage devices mayscrew into the patient's bone tissue to secure the dentition couplingdevice 124. An example of a dentition coupling device that is securedusing a temporary anchorage device is illustrated and described withrespect to at least FIG. 6.

In some embodiments, the dentition coupling device 144 includes one ormore fiducial markers, such as hemispherical inserts, that can be usedto establish a static relationship between the position of the clutch140 and the patient's dentition. For example, the dentition couplingdevice 144 may include three fiducial markers disposed along itssurface. The location of these fiducial markers can then be determinedrelative to the patient's dentition such as by capturing a physicalimpression of the patient with the clutch attached or using imagingtechniques such as capturing a digital impression (e.g., with anintraoral scanner) or other types of images of the dentition andfiducial markers.

The position indicator system 128 is a system that is configured to beused to determine the position and orientation of the clutch 120. Insome embodiments, the position indicator system 128 includes multiplefiducial markers. In some examples, the fiducial markers are spheres.Spheres work well as fiducial markers because the location of the centerof the sphere can be determined in an image regardless of the angle fromwhich the image containing the sphere was captured. The multiplefiducial markers may be disposed (e.g., non-collinearly) so that bydetermining the locations of each (or at least three) of the fiducialmarkers, the position and orientation of the clutch 120 can bedetermined. For example, these fiducial markers may be used to determinethe position of the position indicator system 128 relative to thedentition coupling device 124, through which the position of theposition indicator system 128 relative to the patient's dentition can bedetermined.

In some embodiments, the position indicator system 128 comprises a lightsource assembly that emits beams of light. The light source assembly mayemit substantially collimated light beams (e.g., laser beams). In someembodiments, the light source assembly is rigidly coupled to thedentition coupling device 124 so that as the dentition coupling device124 moves with the patient's dentition, the beams of light move. Theposition of the dentition coupling device 124 is then determined bycapturing images of where the light beams intersect with varioussurfaces (e.g., translucent screens disposed around the patient).Embodiments that include a light source assembly are illustrated anddescribed throughout.

The reference structure 122 is a structure that is configured to be wornby the patient so as to provide a point of reference to measure themotion of the clutch 120. In embodiments where the clutch 120 isconfigured to couple to the patient's lower dentition, the referencestructure 122 is configured to mount elsewhere on the patient's head sothat the motion of the clutch 120 (and the patient's mandible) can bemeasured relative to the rest of the patient's head. For example, thereference structure 122 may be worn on the upper dentition.Beneficially, when the reference structure 122 is mounted securely tothe patient's upper dentition, the position of the reference structure122 will not be impacted by the movement of the mandible (e.g., muscleand skin movement associated with the mandibular motion will not affectthe position of the reference structure). Alternatively, the referencestructure 122 may be configured to be worn elsewhere on the patient'sface or head.

In some embodiments, the reference structure 122 is similar to theclutch 120 but configured to be worn on the dental arch opposite theclutch (e.g., the upper dentition if the clutch 120 is for the lowerdentition). For example, the reference structure 122 shown in FIG. 2includes a dentition coupling device 130 that may be similar to thedentition coupling device 124, and a position indicator system 134 thatmay be similar to the position indicator system 128.

FIG. 3 illustrates an embodiment of a clutch 400. The clutch 400 is anexample of the clutch 120. In this example, the clutch 400 includes adentition coupling device 402 and a light source assembly 404, and anextension member 408. The dentition coupling device 402 is an example ofthe dentition coupling device 124, and the light source assembly 404 isan example of the position indicator system 128.

The light source assembly 404 is a device that emits light beamscomprising light that is substantially collimated. Collimated lighttravels in one direction. A laser beam is an example of collimatedlight. In some embodiments, the light source assembly 404 includes oneor more lasers. Although alternatives are possible, the one or morelasers may be semiconductor lasers such as laser diodes or solid-statelasers such as diode-pumped solid state lasers.

In some embodiments, the light source assembly 404 comprises a first,second, and third light source. The first and second light sources mayemit substantially collimated light in parallel but opposite directions(i.e., the first and second light sources may emit light in antiparalleldirections) such as to the left and right of the patient when the clutch400 is coupled to the patient's dentition. In some embodiments, thefirst and second light sources are collinear or are substantiallycollinear (e.g., offset by a small amount such as less than 5micrometers, less than 10 micrometers, less than 25 micrometers, lessthan 50 micrometers, or less than 100 micrometers). The third lightsource may emit substantially collimated light in a direction of a linethat intersects with or substantially intersects with linescorresponding to the direction of the first and second light sources.Lines that intersect share a common point. Lines that substantiallyintersect do not necessarily share a common point, but would intersectif offset by a small amount such as less than 5 micrometers, less than10 micrometers, less than 25 micrometers, less than 50 micrometers, orless than 100 micrometers. In some embodiments, the third light sourceemits light in a direction that is perpendicular to the first and secondlight sources, such as toward the direction the patient is facing. Insome embodiments, one or more compensation factors are determined tocompensate for an offset from the first and second light source beingcollinear, an offset from the third light source emitting light in adirection of a line that intersects with the directions of the first andsecond light sources, and/or the third light source being offset fromperpendicular to the first and second light sources.

Alternatively, some embodiments of the light source assembly 148 includea single light source and use one or more beam splitters such as prismsor reflectors such as mirrors to cause that light source to function asmultiple light emitters by splitting the light emitted by that lightsource into multiple beams. In at least some embodiments, the emittedlight emanates from a common point. As another example, some embodimentsof the light source assembly 404 may comprise apertures or tubes throughwhich light from a common source is directed.

In the example of FIG. 3, the light source assembly 404 includes lightemitters 406 a, 406 b, and 406 c (referred to collectively as lightemitters 406) and a housing 410. The light emitter 406 a is emitting alight beam L1, the light emitter 406 b is emitting a light beam L2, andthe light emitter 406 c is emitting a light beam L3. The light beams L1and L2 are parallel to each other, but directed in opposite directions.The light beam L3 is perpendicular to the light beams L1 and L2. In atleast some embodiments, the housing 410 is configured to position thelight emitters 406 so that the light beams L1, L2, and L3 areapproximately co-planar with the occlusal plane of the patient'sdentition.

The housing 410 may be approximately cube shaped and includes aperturesthrough which the light emitters 406 extend. In other embodiments, thelight emitters do not extend through apertures in the housing 410 andinstead light emitted by the light emitters 406 passes through aperturesin the housing 410.

In the example of FIG. 3, the dentition coupling device 402 is rigidlycoupled to the light source assembly 404 by an extension member 408. Theextension member 408 extends from the dentition coupling device 402 andis configured to extend out of the patient's mouth when the dentitioncoupling device 402 is worn on the patient's dentition. In someembodiments, the extension member 408 is configured so as to bepermanently attached to the light source assembly 404 such as by beingformed integrally with the housing 410 or joined via welding or apermanent adhesive. In other embodiments, the extension member 408 isconfigured to removably attach to the light source assembly 404. Becausethe light source assembly 404 is rigidly coupled to the dentitioncoupling device 402, the position and orientation of the dentitioncoupling device 402 can be determined from the position and orientationof the light source assembly 404.

In some embodiments, the housing 410 and the dentition coupling device402 are integral (e.g., are formed from a single material or are coupledtogether in a manner that is not configured to be separated by a user).In some embodiments, the housing 410 includes a coupling structureconfigured to removably couple to the extension member 408 of thedentition coupling device 402. In this manner, the dentition couplingdevice 402 can be a disposable component that may be custom fabricatedfor each patient, while the light source assembly 404 may be reused withmultiple dentition coupling devices. In some embodiments, the housing410 includes a connector that is configured to mate with a connector onthe dentition coupling device 402. Additionally or alternatively, thehousing 410 may couple to the dentition coupling device 402 with amagnetic clasp. Some embodiments include a registration structure thatis configured to cause the housing 410 to join with the dentitioncoupling device 402 in a repeatable arrangement and orientation. In someembodiments, the registration structure comprises a plurality of pinsand corresponding receivers. In an example, the registration structureincludes a plurality of pins disposed on the housing 410 andcorresponding receivers (e.g., holes) in the dentition coupling device402 (or vice versa). In some embodiments, the registration structurecomprises a plurality of spherical attachments and a plurality ofgrooves. In one example, the registration structure includes three ormore spherical attachments disposed on the housing 410 and two or morev-shaped grooves disposed on the dentition coupling device 402 that aredisposed such that the spherical attachments will only fit into thegrooves when the housing 410 is a in a particular orientation andposition relative to the dentition coupling device 402.

FIG. 4 illustrates an example embodiment of a dentition couplingframework 170 that can be included in a dentition coupling device suchas the dentition coupling device 124 or the dentition coupling device130. Some embodiment of a dentition coupling device also include animpression device 200 that is not shown in FIG. 4, but is illustratedand described with respect to at least FIG. 5.

The dentition coupling framework 170 includes a dentition facing surface176, a contact surface 178, and an extension member 182. The dentitionfacing surface 176 is configured to align with the patient's dentitionand face towards the occlusal surface of the patient's dentition. Inthis example, the dentition facing surface 176 is configured to hold animpression tray, which may be secured to the dentition couplingframework 170 using one or more fastening devices such as screws. Inthis example, the dentition facing surface 176 includes holes 180 thatare configured for use with fastening devices to couple to an impressiontray. In other embodiments, the dentition coupling framework 170 isconfigured to couple directly to the patient's dentition or isconfigured to attach to another type of coupling device such as a moldshaped to fit the patient's dentition.

The contact surface 178 is configured to contact the patient's opposingdentition or a structure coupled to the patient's opposing dentitionsuch as the reference structure 122. In the example shown, the contactsurface 178 includes three regions that have generally flat surfaces forcontact. The holes 180 are recessed between these regions of the contactsurface 178. In some embodiments, the regions of the contact surface 178are generally parallel with the dentition facing surface. However, thecontact surface 178 in this example faces in a direction opposite of thedentition facing surface 176. In some embodiments, the contact surface178 is separated from the dentition facing surface 176 by a distance D.In some embodiments, this distance D corresponds to the height of thedentition coupling device in the occlusal dimension. In someembodiments, the distance D is selected so as to permit the top of afastening device (e.g., screw heads or knobs) to extend up from theholes 180 without extending to the contact surface 178. Beneficially,such an arrangement prevents the fastening device from making contactwith the patient's opposing dentition or the reference structure 122.

Additionally, in some embodiments, the distance D is selected to createa desired occlusal separation between the patient's lower dentition andupper dentition. In some embodiments, the distance D is equal to half ofthe desired occlusal separation so that the patient can wear a referencestructure 122 that also has a similar height and in combination with aclutch that includes the dentition coupling device 160 causes thepatent's lower dentition and upper dentition to be separated by adesired amount. In some embodiments, the desired amount of occlusalseparation is configurable based on the patient's dental anatomy.

The extension member 182 extends from the dentition coupling framework170 and is configured to extend out of the patient's mouth when thedentition coupling framework 170 is worn on the patient's dentition. Insome embodiments, the extension member 182 is configured so as to bepermanently attached to the housing 410 such as by being formedintegrally or joined via welding or a permanent adhesive. In otherembodiments, the extension member 182 is configured to removably attachto the housing 410. For example, as shown in FIG. 4, the extensionmember 182 includes a hole 184, which is configured to receive afastening device (e.g., a screw) to fasten the extension member 182 tothe housing 410. In some embodiments, one or both of the extensionmember 182 and the housing 410 includes alignment structures such asprotrusions, ridges, or notches that are configured to cause theextension member 182 and the housing 410 to join together in a uniformand repeatable manner. Additionally or alternatively, some embodimentsuse magnets to couple the extension member 182 and the housing 410.

FIG. 5 illustrates an example impression device 200 that is configuredto mate with the dentition coupling framework 170 to form an embodimentof the dentition coupling device 124. The illustration in FIG. 5 showsthe part of the impression device 200 that would face the patient'sdentition oriented toward the top. Thus, the illustration in FIG. 5shows the impression device 200 rotated 180 degrees from how it would beoriented when mated with the dentition coupling framework 170 of FIG. 3.

In this example, the impression device 200 includes an inner surface 202that forms a trough 204 that roughly approximates the shape of thedental arch. In some embodiments, the cross-sections of the innersurface 202 (i.e., that are made perpendicular to the dental arch) arealso arch shaped. The trough 204 is configured to hold a securingmaterial such as impression material or an adhesive material thatoperates to secure the impression device to the dentition of thepatient. Additionally, in some embodiments, the impression device 200also includes one or more internal fiducial markers 206, a matingsurface 208, and one or more fastening structures 210.

The internal fiducial markers 206 may be similar to the fiducial markers174. However, in at least some embodiments, the internal fiducialmarkers 206 are smaller than the fiducial markers 174 so as to fit inthe patient's mouth more comfortably. Additionally, in some embodiments,the internal fiducial markers 206 may be removable, so that the internalfiducial markers 206 can be removed when the impression device 200 isplaced in a patient's mouth. The internal fiducial markers 206 areconfigured so that when imaged (e.g., by the imaging system 102), theposition of the internal fiducial markers 206 can be determined. Variousembodiments include various numbers of internal fiducial markers.

In some embodiments, the internal fiducial markers 206 are imaged whenthe impression device 200 is coupled to the dentition coupling framework170 and the framework 172 to determine or confirm the relationshipbetween the position of the impression device 200 and the fiducialmarkers 174 that are attached to the framework 172. However, in someembodiments, the relationship between the position of the impressiondevice 200 and the fiducial markers 174 is determined based on a knownfixed relationship between the devices and thus it is not necessary tocapture images containing both the internal fiducial markers 206 and thefiducial markers 174.

In some embodiments, the internal fiducial markers 206 are imaged withan impression taken using the impression device 200 (e.g., hardenedimpression material in the trough 204) to determine a relationshipbetween the position of the patient's dentition and the impressiondevice 200 (and therefore the rest of the clutch).

The mating surface 208 is configured to fit against the dentition facingsurface 176 when the impression device 200 is coupled to the dentitioncoupling framework 170. Additionally, the fastening structures 210 areconfigured to align with the holes 180 of the dentition couplingframework 170 and operate to join the impression device 200 to thedentition coupling framework 170. In some embodiments, the fasteningstructures 210 are knobs that fit through the holes 180 and may containa hole for a screw or another fastener. Alternatively, the knobs andholes may be oblong shaped so that when mated the knobs can be twistedto secure the impression device 200 to the dentition coupling framework170. Other embodiments include other fastening mechanisms.

FIG. 6 illustrates an example dentition coupling device 212. Thedentition coupling device 212 is an embodiment of a dentition couplingdevice such as the dentition coupling device 124. The dentition couplingdevice 212 is configured to couple to a patient's dentition usingtemporary anchorage devices such as temporary anchorage devices 222 aand 222 b. The dentition coupling device 212 includes an arch portion214 and securing regions 218 a and 218 b. The arch portion 214 is arigid structure and may be shaped to fit along a surface of thepatient's dentition. The arch portion 214 may be custom fabricated for apatient based on an impression of the patient's dentition ormeasurements of the patent's dentition. The arch portion 214 may includea contoured portion 216 that has a shape that matches the lingual/buccal(outer) surfaces of at least some of the patient's teeth. For example,the dentition coupling device 212 may be produced using rapidfabrication technology based on an impression of the patient'sdentition. However, in some embodiments, the dentition coupling device212 does not include a contoured portion (e.g., when a patient iscompletely or primarily edentulous).

In some embodiments, the securing regions 218 a and 218 b includesurfaces that match the contour of portions of the patient's dentition(e.g., based on a previously captured impression of the patient'sdentition). The securing regions may align with an edentulous region ofthe patient's dentition or another portion of the patient's dentition.Although the example shown in FIG. 6 includes two securing regions, thedentition coupling device 212 can include just one securing region ormore than two securing regions.

The securing regions 218 a and 218 b include fastener receivers 220 aand 220 b respectively. The fastener receivers 220 a and 220 b areconfigured to receive a fastener such as the temporary anchorage devices222 a and 222 b. In some embodiments, the fastener receivers 220 a and220 b are apertures through which the bone penetrating portions of thetemporary anchorage devices 222 a and 222 b may pass. The fastenerreceivers 220 a and 220 b may be sized so as to prevent the heads of thetemporary anchorage devices 222 a and 222 b from passing. In thismanner, the temporary anchorage devices 222 a and 222 b secure thedentition coupling device 212 to the patient's dentition.

Alternatively, the fastener receivers 220 a and 220 b include clasps tocouple to the heads of temporary anchorage devices 222 a and 222 b. Inthese embodiments, the temporary anchorage devices 222 a and 222 b maybe inserted into the patient's bone tissue before the dentition couplingdevice 212 is placed on the patient's dentition. Then, the dentitioncoupling device 212 can be placed on the patient's dentition so that theclasps couple with the heads of the already implanted temporaryanchorage devices 222 a and 222 b.

In these embodiments, the temporary anchorage devices 222 a and 222 bmay be placed in the patient's dentition. After the temporary anchoragedevices 222 a and 222 b are placed, an impression of the patient'sdentition can be captured. The dentition coupling device 212 can then becustom designed based on that impression to match at least a portion ofthe contour of the patient's dentition and to include clasps to matewith the implanted temporary anchorage devices 222 a and 222 b. Thedentition coupling device 212 can then be fabricated using for examplerapid fabrication technologies.

The temporary anchorage devices 222 a and 222 b are fastening devicesformed from a biocompatible material (e.g., titanium) that areconfigured to penetrate through the patient's gum tissue and into thepatient's bone tissue. The temporary anchorage devices 222 a and 222 bmay include threads that are configured to secure the temporaryanchorage devices 222 a and 222 b. The temporary anchorage devices 222 aand 222 b may include heads with various configurations. For example,the temporary anchorage devices 222 a and 222 b may include a receiverfor a tightening tool. Additionally or alternatively, the temporaryanchorage devices 222 a and 222 b may include a head with a sphericalshape that can serve as a fiducial for determining the relationshipbetween the dentition coupling device 212 and the patient's dentition.Alternatively, when the dentition coupling device 212 is customfabricated to fit a particular patient's dentition, the relationshipbetween the dentition coupling device 212 and the patient's dentitionmay be inferred.

FIG. 7 illustrates a top view of an embodiment of a reference structure430 and an embodiment of an imaging system 432. The reference structure430 is an example of the reference structure 122. The imaging system 432is an example of the imaging system 102.

The reference structure 430 may be similar to the clutch 400, exceptthat the reference structure 430 is configured to be worn on theopposite arch from the clutch 400. The reference structure 430 includesa dentition coupling device 434, and extension member 44, and a lightsource assembly 442. The dentition coupling device 434 is an example ofthe dentition coupling device 130 and may be similar to the exampledentition coupling devices previously described with respect toembodiments of the clutch. The extension member 440 is an example of theframework 132 and the light source assembly 442 is an example of theposition indicator system 134.

The dentition coupling device 434 is configured to removably couple tothe dentition of the patient. The dentition coupling device 434 iscoupled to the opposite arch of the patient's dentition as the clutch(e.g., the dentition coupling device 434 couples to the maxillary archwhen the clutch 400 is coupled to the mandibular arch). In someembodiments, the dentition coupling device 434 is coupled to theextension member 440 that is configured to extend out through thepatient's mouth when the dentition coupling device 434 is coupled to thepatient's dentition. The extension member 440 may be similar to theextension member 408.

In the embodiment shown, the extension member 440 is rigidly coupled toa light source assembly 442. The light source assembly 442 may bepermanently coupled to the extension member 440. In other embodiments,the extension member 440 is configured to removably couple to the lightsource assembly 442. For example, the extension member 440 may couple tothe light source assembly 442 via a thumb screw or another type offastener.

The imaging system 432 includes a screen framework 436, screens 438 a,438 b, and 438 c (referred to collectively as screens 438), and cameras420 a, 420 b, and 420 c (referred to collectively as cameras 420).

The screen framework 436 is a structure that positions the screens 438to surround a patient's mouth so that light emitted by the referencestructure 430 or a clutch (not shown) worn by the patient will intersectwith the screens 438. Although alternatives are possible, the screenframework 436 may be U-shaped, having one side for each of the screens438. In this example, the screen framework 436 orients the screen 438 cat a right angle from screen 438 a and at a right angle from screen 438b. In some embodiments, the screen framework 436 is configured toconnect to the top of the screens 438 (e.g., if the screens 438 areformed from a rigid material). Alternatively, the framework maypartially or fully surround the screens 438 (e.g., if the screens 438are formed from a flexible material).

Other embodiments may include different numbers of the screens 438 anddifferent arrangements of the light source assembly 442. For example,some embodiments may include two light emitters and two screens. One ofthe screens may be disposed in front of the patient (i.e., in theanterior direction) and one may disposed on one side of the patient(i.e., in a lateral direction). Additionally, some embodiments mayinclude a third light source that emits light up or down (i.e., in thesuperior or inferior direction).

The screens 438 may be formed from a translucent material so that thepoints where the light beams emitted by the light source assembly 442intersect with the screens 438 may be viewed from outside of the screens438. Images that include these points of intersection may be recorded bythe imaging system 102. The motion determining device 106 may thenanalyze these captured images to determine the points of intersection ofthe light beams with the screens 438 to determine the location of thelight source assembly 442. The position of the light source assembly 404of the clutch 400 (not shown) may be determined in a similar manner.

The cameras 420 are positioned and oriented to capture images of thescreens 438. For example, the camera 420 a is positioned and oriented tocapture images of the screen 438 a, the camera 420 b is positioned andoriented to capture images of the screen 438 b, and the camera 420 c ispositioned and oriented to capture images of the screen 438 c. In someembodiments, the cameras 420 are mounted to the screen framework 436 sothat they move with the screen framework 436. For example, each of thecameras 420 may be coupled to the screen framework 436 by a cameramounting assembly such as is shown in FIG. 10. In this manner, theposition and orientation of the cameras 420 relative to the screens 438does not change if the screen framework 436 is moved.

The cameras 420 may store a series of images or transmit images as theimages are captured to a storage device or a computing device such asthe motion determining device 106. In some embodiments, the cameras 420transmit images over a wired network. In other embodiments, the cameras420 transmit images over a wireless network.

The system 100 may include techniques to compensate for variations inthe alignment of the cameras to the screens or the screens to oneanother. For example, a calibration pattern of known shape anddimensions may be projected onto the screens and captured with thecameras. The recorded images may be analyzed to identify deviations fromthe known shape and dimensions. A translation can then be generated totranslate the captured image to the expected shape and dimensions. Thisis one example of a method to compensate for variations in alignment;other methods are used in other embodiments. Similar methods can be usedto compensate for variations in the relative positions of the screens(e.g., by projecting a pattern of known relation on multiple screens).In one example, light that is expected to be collinear is projected onmultiple screen simultaneously. Any deviations in the collinearity ofthe light in the captured images can then be compensated (e.g., using atransformation). Similar techniques can also be used to compensate forfield of view distortion in the cameras. An example calibration plate isillustrated and described with respect to at least FIG. 19.

FIG. 8 illustrates an embodiment of the patient assembly 460. Thepatient assembly 460 is an example of the patient assembly 104. Thepatient assembly 460 includes a clutch 462 and a reference structure464.

The clutch 462 may be similar to the clutch 400. However, the clutch 462includes a plurality of internal fiducial markers 466. The internalfiducial markers 466 are usable to establish a static relationshipbetween the clutch and the patient's dentition. The internal fiducialmarkers 466 may be similar to the internal fiducial markers 206.Additionally, the internal fiducial markers 466 may be used to establisha static relationship between a dentition coupling device of the clutch462 and a light source assembly of the clutch 462. Various embodimentsinclude various numbers of the internal fiducial markers 466.

The reference structure 464 may be similar to the reference structure430. However, the reference structure 464 includes internal fiducialmarkers 468 that are usable to establish a static relationship betweenthe reference structure 464 and the patient's dentition. The internalfiducial markers 468 may be similar to the internal fiducial markers206. Various embodiments include various numbers of the internalfiducial markers 468.

Additionally, the reference structure 464 includes the light sourceassembly 442. The light source assembly 442 includes light emitters 472a, 472 b, and 472 c that emit light beams L4, L5, and L6. Similar to thelight beams L1, L2, and L3 emitted by the clutch 462, the light beamsL4, L5, and L6 are directed to intersect with screens (not shown) suchas the screens 438.

The light beams L4, L5, and L6 may have a different color (i.e., have adifferent wavelength) than the light beams L1, L2, and L3. In thismanner, the motion determining device 106 can distinguish the lightbeams L1, L2, and L3 from the light beams L4, L5, and L6 so that therelative positions of the light source assemblies on the clutch 462 andthe reference structure 464.

Additionally or alternatively, the light source assembly 442 of thereference structure 464 and the light source assembly 404 of the clutch462 may strobe on and off in a synchronized manner so that the motiondetermining device 106 may determine which points on the images of thescreens 438 (not shown) correspond to the light source assembly 442 fromthe reference structure 464 and which correspond to the light sourceassembly 404 of the clutch 462. For example, the imaging system 102 maycapture sequential frames of images, while the light source assembly onthe clutch 462 may be activated during odd frames and the light sourceassembly on the reference structure 464 may be activated during evenframes (or vice versa). For example, the light source assembly on theclutch 462 may emit light in phases (e.g., alternating between an onphase and an off phase) and the light sources assembly on the referencestructure may emit light in phases (e.g., alternating between areference on phase and a reference off phase) that are out of phase witheach other (e.g., the light source assembly of the clutch is on when thelight source assembly of the reference structure is off, and the lightsource assembly of the clutch is off when the light source assembly ofthe reference structure is on).

As another example, one of the light source assemblies may strobe, whilethe other does not, or both may strobe but at different frequencies orwith different patterns. Another alternative is that the light beamsemitted from the reference structure 464 are distinguished from thelight beams emitted by the clutch 462 based on position (e.g., the beamsthat are higher may be determined to be emitted by the referencestructure 464 as it is configured to attach to the upper arch).

FIG. 9 illustrates an embodiment of a light source assembly 510 thatuses a single laser source. The light source assembly 510 may be similarto the previously described light source assemblies such as the lightsource assembly 404. The light source assembly 510 emits three laserbeams L1, L2, and L3 from a single laser emitter 516.

The light source assembly includes a housing 512, fiducial markers 514,the laser emitter 516, and a beam splitter assembly 518.

The housing 512 surrounds the light source assembly 510 and beamsplitter assembly 518. The housing 512 may contain one or more aperturesthrough which light may be emitted by the light source assembly 510. Insome embodiments, the housing 512 is formed from a rigid or semi-rigidmaterial, such as plastic, metal, ceramic, or a composite material. Insome embodiments the housing 512 may be a single integral component.Alternatively, the housing 512 may include a coupling structureconfigured to removably couple together the multiple components of thehousing. In some embodiments, the top component of the housing 512includes a connector that is configured to mate with a connector on thebottom component of the housing 512. The components of the housing mayalso include holes or receivers for screws or other fasteners to couplethe components together.

The light source assembly 510 also includes one or more fiducial markers514 disposed on a surface of the housing 512 that can be used toestablish the position of the light source assembly 510 relative to aclutch such as the clutch 400 or a reference structure such as thereference structure 430. Some embodiments do not include fiducialmarkers and the relationship between the light source assembly 510 andthe clutch or reference structure is established in advance such as whenthe light source assembly is 510 is permanently coupled to the clutch orreference structure. The relationship may be established based on thedesign of the clutch or reference structure. To address potentialmanufacturing variances, the clutch or the reference structure may becharacterized using a touch probe or similar device.

In the example of FIG. 9, the light source assembly 510 includes asingle laser emitter 516. Although alternatives are possible, the laseremitter 516 may be a semiconductor laser emitter such as a laser diodeemitters or a solid-state laser emitter such as diode-pumped solid statelaser emitter. The laser emitter 516 emits a beam of collimated lightinto the beam splitter assembly 518.

The beam splitter assembly splits the laser beam emitted by the laseremitter 516 into three separate light beams L1, L2, and L3. In someembodiments, the beam splitter assembly 518 contains three reflectorsurfaces 520, 526, and 528 and two beam splitters 522 and 524. In thisexample, the collimated light from the laser emitter 516 is initiallyemitted as a vertical light beam on to the first reflector surface 520.The vertical light beam is then reflected by the first reflector surface520 to form a horizontal light beam. In some embodiments, the laseremitter 516 is orientated to emit the light beam horizontally and thefirst reflector surface 520 is omitted.

This horizontal light beam then passes through the first beam splitter522. The first beam splitter 522 splits the horizontal light beam intotwo light beams that are substantially orthogonal to one another. One ofthe light beams is emitted out of the housing of the light sourceassembly 510 as light beam L1, while the other light beam continues in adirection that is the same as or similar to the direction of thehorizontal light beam.

The horizontal light beam continues on until it reaches the second beamsplitter 524. The second beam splitter 524 again splits the horizontallight beam into two light beams that are substantially orthogonal to oneanother. One of the light beams continues in the same direction as theincoming horizontal light beam and is emitted out of the housing of thelight source assembly 510 as light beam L3. The other light beam travelsin a direction that is substantially orthogonal to the light beam L3 andopposite the light beam L1. This light beam continues until it reachesthe second reflector surface 526. The second reflector surface 526reflects the light beam orthogonally such that it travels in theopposite direction as light beam L3 until reaching the third reflectorsurface 528. The third reflector surface 528 once again reflects thelight beam orthogonally to produce the light beam L2 travelling in adirection that is substantially opposite to but collinear with the lightbeam L1. The reflected light beam is emitted out of the housing of thelight source assembly 510 as light beam L2. In some aspects, the secondbeam splitter 524, the second reflector surface 526, and the thirdreflector surface 528 are disposed so as to cause the light beam L1 andthe light beam L2 to be collinear.

In some embodiments, the light beams L1 and L2 are substantiallyparallel to each other, but directed in opposite directions, and thelight beam L3 is substantially perpendicular to the light beams L1 andL2. Further, in some embodiments, the light beams L1 and L2 arecollinear. In at least some embodiments, the light source assembly 510is configured to position the laser emitter 516 so that the light beamsL1, L2, and L3 are approximately co-planar with the occlusal plane ofthe patient's dentition.

Alternatively, some embodiments, are configured so that the light beamsL1 and L2 are not collinear when emitted. These embodiments, may omitthe second reflector surface 526 and the third reflector surface 528.

FIG. 10 illustrates an embodiment of an imaging system 530. The imagingsystem 530 is another example of the imaging system 102.

This example embodiment of the imaging system 530 includes the cameras420 a, 420 b and 420 c, a stand 532, camera mounting assemblies 534 a,534 b, and 534 c. The imaging system 530 also includes the screenframework 436, and the screens 438 a, 438 b, and 438 c.

The stand 532 is a structure that positions the imaging system for usein capturing movement of a clutch and reference structure in a patient'smouth. The stand 532 includes legs 536 a, 536 b, 536 c, 536 d (referredto collectively as legs 536) and mounting framework 538.

The legs vertically position the mounting framework 538. Someembodiments of the stand 532 are designed to be placed on the floor andthe legs 536 have a longer length. Other embodiments of the stand 532are designed to be placed on an elevated surface such as a countertop ortable top and the legs 536 have a shorter length. The length of the legs536 may be fixed or adjustable.

The mounting framework 538 is a structure that other components of theimaging system 530 are mounted to. In some embodiments, the mountingframework 538 comprises a plurality of horizontally oriented elongatemembers. In other embodiments, the mounting framework 538 may include asurface as well. As shown in FIG. 10, the camera mounting assemblies 534and the stand framework are mounted to the mounting framework 538.

The camera mounting assemblies 534 are assemblies that position andorient the cameras 420 relative to the screens 438. The camera mountingassemblies 534 may include various components to adjust the position andorientation of the cameras 420. In at least some embodiments, theposition of the cameras 420 on the camera mounting assemblies 534 isselected so that the field of view of the cameras 420 approximatelycoincides with the screens 438. Alternatively, the field of view of thecameras 420 may approximately coincide with a portion of the screen inwhich the light emitted by a clutch device would be likely to intersect.

For purposes of explanation, the camera mounting assembly 534 b isdescribed in greater detail herein. This discussion is equallyapplicable to the camera mounting assemblies 534 a and 534 b. The cameramounting assembly 534 b includes a sliding rail 540 and a verticalpositioning system 542.

The sliding rail 540 is mounted to the mounting framework 538 below thescreen 438 b. The sliding rail 540 extends away from the screen 438 b ina direction that is approximately normal to the surface of the screen438 b. The sliding rail 540 includes a channel and a sliding element towhich the bottom end of the vertical positioning system 542 isconnected. The sliding element can slide through the channel to adjustthe distance of the camera 420 b from the screen 438 b. The sliding rail540 also includes a locking mechanism, which when engaged prevents thesliding element from moving through the channel.

The vertical positioning system 542 is mounted to the movable element onone end and the camera 420 b on the other. The vertical positioningsystem 542 is a structure that vertically positions the camera 420 b. Insome embodiments, the height of the vertical positioning system 542 isadjustable. For example, the vertical positioning system 542 may includea telescoping component that slides up and down to adjust the height ofthe vertical positioning system 542. The vertical positioning system 542may also include a locking component that prevents the telescopingelement from moving so as to lock the height of the vertical positioningsystem 542.

FIG. 11 illustrates a perspective view of the clutch 400 disposed withinthe screens 438 of the imaging system. In this example, the screen 438 cis shown as transparent so that the clutch 400 can be seen.

In this example, the light emitter 406 a is emitting a light beam L1,which intersects with the screen 438 a at intersection point I1; thelight emitter 406 b is emitting a light beam L2, which intersects withthe screen 438 b at intersection point I2; and the light emitter 406 cis emitting a light beam L3, which intersects with the screen 438 c atintersection point I3. As the position and orientation of the clutch 400changes relative to the screens 438, the location of at least some ofthe intersection points I1, I2, and I3 will change as well.

The camera 420 c captures an image of the screen 438 c, including theintersection point 13 of the light beam L3 emitted by the light emitter406 c. The camera 420 c may capture a video stream of these images.Similarly, although not shown in this illustration, cameras 420 a and420 b capture images of the screens 438 a and 438 b and the intersectionpoints I1 and I2.

The captured images from the cameras 420 are then transmitted to themotion determining device 106. The motion determining device 106 maydetermine the location of the intersection points I1, I2 and I3, andfrom those points the location of the light source assembly 404. In someembodiments, a point of common origin within the light source assembly404 for the light beams L1, L2, and L3 is determined based on thelocation of the intersection points I1, I2, and I3 (e.g., the point atwhich the light beams intersect). Based on the determined locations ofthe light beams, the location and orientation of the clutch 400 relativeto the screens 438 can be determined.

In other embodiments, the motion determining device 106 fits theintersection points I1, I2, and I3 to a plane. The motion determiningdevice 106 then determines the location of the light source assembly 404by finding an intersection point of the light beam L3 with either oflight beams L2 or L3.

FIG. 12 illustrates a perspective view of a reference structure 560. Thereference structure 560 is configured to mount to an imaging system suchas the imaging system 102. In some embodiments, the imaging system 102is supported by and moves with the reference structure 560. In otherembodiments, the imaging system 102 secures the reference structure 560so that the reference structure 560 cannot move and consequently thepatient's upper jaw and head cannot move.

The reference structure 560 includes the dentition coupling device 434,the extension member 440, a housing 562, and a framework mountingassembly 564. The housing 562 is a structure that includes a connectorfor connecting with the framework mounting assembly 564. The housing 562may include features such as notches or ridges that operate to ensurethat the connection to the framework mounting assembly 564 is repeatableand consistent (e.g., when connected the relative orientation andposition of the housing 562 and framework mounting assembly 564 arealways substantially the same). In some embodiments, the housing 562 isformed from a rigid or semi-rigid material, such as plastic, metal,ceramic, or a composite material. In some embodiments the housing 562and the dentition coupling device 434 are integral (e.g., are formedfrom a single material or are coupled together in a manner that is notconfigured to be separated by a user). Alternatively, the housing 562may include a connector for establishing a consistent and repeatableconnection with the extension member 440. Although not shown in FIG. 12,some embodiments of the housing 562 house a light source assembly suchas the light source assembly 442 or other components as well.

In the embodiment shown, the framework mounting assembly 564 includes aframework mounting post 566. The framework mounting post 566 is a postthat extends from the housing 562 approximately vertically up above apatient's mouth when the reference structure 560 is being worn by thepatient. The framework mounting post 566 is configured to connect to thescreen framework as shown in FIG. 13.

FIG. 13 illustrates a top view of an embodiment of the referencestructure 560 mounted to an imaging system 570. The imaging system 570is another example of the imaging system 102.

The reference structure 560 is mounted to the imaging system 570 withthe framework mounting assembly 564. In the embodiment shown, theframework mounting assembly 564 includes the framework mounting post 566and a framework mounting extension member 568. The framework mountingassembly 564 is a rigid structure that operates to couple the screenframework 436 to the dentition coupling device 434. The frameworkmounting extension member 568 is joined to an end of the frameworkmounting post 566 that is opposite of the dentition coupling device 434.The framework mounting extension member 568 extends horizontally outaway from the patient's mouth when the reference structure 560 is beingworn by the patient.

The framework mounting extension member 568 may have different sizes invarious embodiments as well and the size may depend on the size of thescreens 438. For example, the framework mounting extension member 568may have a length that positions the horizontal center of screens 438 aand 438 b to approximately line up with the patient's lips. In thismanner, the framework mounting assembly 564 serves to help ensure thepatient stays approximately centered in the screens during measurementoperations.

FIG. 14 illustrates a perspective view of part of the referencestructure 560 and part of the imaging system 570.

The reference structure 560 includes a dentition coupling device 434.The dentition coupling device 434, the screen framework 436, the screens438, the framework mounting assembly 564, the framework mounting post566 and the framework mounting extension member 568 are similar to theexamples previously described.

The framework mounting extension member 568 is attached to the screenframework 436. A camera mounting assembly 480 is also attached to thescreen framework 436. The camera mounting assembly 480 includes a cameramounting extension member 574 and a camera mounting post 576. The cameramounting extension member 574 couples to the screen framework 436 andextends to position the camera 420 c out away from the patient. Thelength of the camera mounting extension member 574 varies in variousembodiments and depends on the size of the screen 438 c and the angle ofview of the camera 420 c. In at least some embodiments, the length ofthe bracket is selected to position the camera 420 c so that the fieldof view of the camera 420 c approximately coincides with the screen 438c. Alternatively, the field of view of the camera 420 c mayapproximately coincide with a portion of the screen in which the lightemitted by a clutch device would be likely to intersect.

FIG. 15 is a schematic block diagram illustrating an example of a system800 for using jaw motion captured by the motion capture system 100 tofabricate a dental appliance 824 or provide dental therapy. In thisexample, the system 800 includes a dental office 802 and a dental lab804.

The example dental office 802 includes a dental impression station 806,the motion capture system 100, and a dental therapy station 826.Although shown as a single dental office in this figure, in someembodiments, the dental office 802 comprises multiple dental offices.For example, in some embodiments, one or both of the dental impressionstation 806 and the motion capture system 100 are in a different dentaloffice than the dental therapy station 826. Further, in someembodiments, one or more of the dental impression station 806, themotion capture system 100, and the dental therapy station 826 are not ina dental office.

The example dental impression station 806 generates a dental impression808 of the dentition of the patient. The dental impression 808 is ageometric representation of the dentition of the patient. In someembodiments, the dental impression 808 is a physical impression capturedusing an impression material, such as sodium alginate, orpolyvinylsiloxane. In other embodiments, other impression materials areused as well. In some embodiments, the dental impression is captured bythe impression device 200 of the motion capture system 100. In otherwords, some embodiments do not include a dental impression station 806that is separate from the motion capture system 100.

In some embodiments, the dental impression 808 is a digital impression.In some embodiments, the digital impression is represented by one ormore of a point cloud, a polygonal mesh, a parametric model, or voxeldata. In some embodiments, the digital impression is generated directlyfrom the dentition of the patient, using for example an intraoralscanner. Example intraoral scanners include the TRIOS Intra Oral DigitalScanner, the Lava Chairside Oral Scanner C.O.S., the Cadent iTero, theCerec AC, the Cyrtina IntraOral Scanner, and the Lythos DigitalImpression System from Ormco. In other embodiments, a digital impressionis captured using other imaging technologies, such as computedtomography (CT), including cone beam computed tomography (CBCT),ultrasound, and magnetic resonance imaging (MRI). In yet otherembodiments, the digital impression is generated from a physicalimpression by scanning the impression or plaster model of the dentitionof the patient created from the physical impression. Examples oftechnologies for scanning a physical impression or model include threedimensional laser scanners and computed tomography (CT) scanners. In yetother embodiments, digital impressions are created using othertechnologies.

The motion capture system 100 has been described previously and capturesa representation of the movement of the dental arches relative to eachother. In some embodiments, the motion capture station generates motiondata 810.

In other embodiments, the motion capture system 100 generates motiondata 810 representing the movement of the arches relative to oneanother. In some embodiments, the motion capture system 100 generatesthe motion data 810 from optical measurements of the dental arches thatare captured while the dentition of the patient is moved. In someembodiments, the optical measurements are extracted from image or videodata recorded while the dentition of the patient is moved. Additionally,in some embodiments, the optical measurements are captured indirectly.For example, in some embodiments, the optical measurements are extractedfrom images or video data of one or more devices (e.g., the patientassembly 104) that are secured to a portion of the dentition of thepatient. In other embodiments, the motion data 810 is generated usingother processes. Further, in some embodiments, the motion data 810includes transformation matrices that represent the position andorientation of the dental arches. Other embodiments of the motion data810 are possible as well.

In some embodiments, still images are captured of the patient'sdentition while the dentition of the patient is positioned in aplurality of bite locations. In some embodiments, image processingtechniques are used to determine the positions of the patient's upperand lower arches relative to each other (either directly or based on thepositions of the attached patient assembly 104). In some embodiments,the motion data 810 is generated by interpolating between the positionsof the upper and lower arches determined from at least some of thecaptured images.

The example dental lab 804 includes a 3D scanner 812, a design system816, a rapid fabrication machine 819, and an appliance fabricationstation 822. Although shown as a single dental lab in this figure, insome embodiments, the dental lab 804 comprises multiple dental labs. Forexample, in some embodiments, the 3D scanner 812 is in a differentdental lab than one or more of the other components shown in the dentallab 804. Further, in some embodiments, one or more of the componentsshown in the dental lab 804 are not in a dental lab. For example, insome embodiments, one or more of the 3D scanner 812, design system 816,rapid fabrication machine 819, and appliance fabrication station 822 arein the dental office 802. Additionally, some embodiments of the system800 do not include all of the components shown in the dental lab 804.

The example 3D scanner 812 is a device configured to create athree-dimensional digital representation of the dental impression 808.In some embodiments, the 3D scanner 812 generates a point cloud, apolygonal mesh, a parametric model, or voxel data representing thedental impression 808. In some embodiments, the 3D scanner 812 generatesa digital dental model 814. In some embodiments, the 3D scanner 812comprises a laser scanner, a touch probe, or an industrial CT scanner.Yet other embodiments of the 3D scanner 812 are possible as well.Further, some embodiments of the system 800 do not include the 3Dscanner 812. For example, in some embodiments of the system 800 wherethe dental impression station 806 generates a digital dental impression,the 3D scanner 812 is not included.

The design system 816 is a system that is configured to generate thedental appliance data 818. In some embodiments, the dental appliancedata 818 is three-dimensional digital data that represents the dentalappliance component 820 and is in a format suitable for fabricationusing the rapid fabrication machine 819.

In some embodiments, the design system 816 comprises a computing deviceincluding user input devices. In some embodiments, the design system 816includes computer-aided-design (CAD) software that generates a graphicaldisplay of the dental appliance data 818 and allows an operator tointeract with and manipulate the dental appliance data 818. In someembodiments, the design system 816 comprises digital tools that mimicthe tools used by a laboratory technician to physically design a dentalappliance. For example, some embodiments include a tool to move thepatient's dentition according to the motion data 810 (which may besimilar to a physical articulator). Additionally, in some embodiments,the design system 816 comprises a server that partially or fullyautomates the generation of designs of the dental appliance data 818,which may use the motion data 810.

The design system 816 may be usable to design one or more dentalappliance and/or dental treatment concurrently. The motion data 810 maybe used to evaluate the interaction between the one or more dentalappliances and/or dental treatments. This may be particularly beneficialin designing complex appliances and planning complex dental treatmentssuch as implant supported denture systems.

In some embodiments, the rapid fabrication machine 819 comprises one ormore three-dimensional printers, such as the ProJet line of printersfrom 3D Systems, Inc. of Rock Hill, S.C. Another example of the rapidfabrication machine 819 is stereolithography equipment. Yet anotherexample of the rapid fabrication machine 819 is a milling device, suchas a computer numerically controlled (CNC) milling device. In someembodiments, the rapid fabrication machine 819 is configured to receivefiles in the STL format. Other embodiments of the rapid fabricationmachine 819 are possible as well.

Additionally, in some embodiments, the rapid fabrication machine 819 isconfigured to use the dental appliance data 818 to fabricate the dentalappliance component 820. In some embodiments, the dental appliancecomponent 820 is a physical component that is configured to be used aspart or all of the dental appliance 824. For example, in someembodiments, the dental restoration component is milled from zirconiumor another material that is used directly as a dental restoration. Inother embodiments, the dental appliance component 820 is a mold formedfrom wax or another material and is configured to be used indirectly(e.g., through a lost wax casting or ceramic pressing process) tofabricate the dental appliance 824. Further, in some embodiments, thedental appliance component 820 is formed using laser sinteringtechnology.

In some embodiments, the appliance fabrication station 822 operates tofabricate a dental appliance 824 for the patient. In some embodiments,the appliance fabrication station 822 uses the dental appliancecomponent 820 produced by the rapid fabrication machine 819. In someembodiments, the dental appliance 824 is a filling, partial crown, fullcrown, veneer, bridge, complete denture, partial denture, implantframework, surgical splint, implant guide, or orthotic splints such asdeprogramming splints and temporomandibular disorder (TMD) splints. Forexample, the implant frameworks may support complete or partial denturesand may be designed using implant framework design softwareapplications. Other embodiments of the dental appliance 824 are possibleas well. In some embodiments, the dental appliance 824 is formed a froman acrylic, ceramic, or metallic material. In some embodiments, thedental impression 808 is used in the fabrication of the dental appliance824. In some embodiments, the dental impression 808 is used to form aplaster model of the dentition of the patient. Additionally, in someembodiments, a model of the dentition of the patient is generated by therapid fabrication machine 819. In some embodiments, the appliancefabrication station 822 comprises equipment and process to perform someor all of the techniques used in traditional dental laboratories togenerate dental appliances. Other embodiments of the appliancefabrication station 822 are possible as well.

In some embodiments, the dental appliance 824 is seated in the mouth ofthe patient in the dental therapy station 826 by a dentist. In someembodiments, the dentist confirms that the occlusal surface of thedental appliance 824 is properly defined by instructing the patient toengage in various bites. Additionally, in some embodiments, the dentistD uses the dental appliance 824 to provide a dental therapy such asorthognathic surgery or placement of one or more dental implants.

Additionally, in some embodiments, the dental office 802 is connected tothe dental lab 804 via a network.

In some embodiments, the network is an electronic communication networkthat facilitates communication between the dental office 802 and thedental lab 804. An electronic communication network is a set ofcomputing devices and links between the computing devices. The computingdevices in the network use the links to enable communication among thecomputing devices in the network. The network can include routers,switches, mobile access points, bridges, hubs, intrusion detectiondevices, storage devices, standalone server devices, blade serverdevices, sensors, desktop computers, firewall devices, laptop computers,handheld computers, mobile telephones, and other types of computingdevices.

In various embodiments, the network includes various types of links. Forexample, the network can include one or both of wired and wirelesslinks, including Bluetooth, ultra-wideband (UWB), 802.11, ZigBee, andother types of wireless links. Furthermore, in various embodiments, thenetwork is implemented at various scales. For example, the network canbe implemented as one or more local area networks (LANs), metropolitanarea networks, subnets, wide area networks (such as the Internet), orcan be implemented at another scale.

FIG. 16 is an example process 850 for designing a dental appliance ortreatment based on captured jaw motion. In some embodiments, the process850 is performed by the system 800.

At operation 852, an initial impression of a patient is acquired. Insome aspects, the initial impression is captured using a digital orphysical impressioning technique. Alternatively, the initial impressionis acquired from a storage location such as a database that storesdental impression data (e.g., from a previous patient visit).

At operation 854, the patient assembly 104 is attached to the patient.As has been described previously, the patient assembly 104 may beattached to the patient's upper and lower dentition so as to capturerelative jaw motion.

At operation 856, a second impression of the patient is captured whilethe patient assembly 104 is attached to the patient. As has beendescribed previously, the patient assembly may include various internalmarkers the location of which may be captured in the second impression.The patient does not necessarily wear the entire patient assembly duringthis operation. For example, the patient may wear the dentition couplingdevice of the clutch and the dentition coupling device of the referencestructure for the second impression.

At operation 858, the initial impression and the second impression arealigned with one another. Various techniques may be used to align theimpressions. In some embodiments, the shape or approximate shape of theattached patient assembly is subtracted from the second impressionbefore performing the alignment. Boolean operations may be used tosubtract the shape of the attached patient assembly. The position of thepatient assembly in the second impression may be determined based on thelocation of the fiducials in the second impression.

At operation 860, a static relationship between the patient assembly andthe patient's dentition is determined. In some embodiments, the staticrelationship is determined based on the alignment of the initialimpression to the second impression. Alternatively or additionally, thestatic relationship may be determined based on the design of the patientassembly. For example, in some embodiments, the patient assembly 104 iscustom fabricated to fit a patient's dentition in a particular manner.In these embodiments, when the patient assembly 104 is properly attachedto the patient's dentition, the static relationship between the patientassembly and the patient's dentition can be determined based on thatdesign. In these embodiments, it may not be necessary to capture animpression of the patient with the patient assembly attached.Additionally, in some embodiments, the static relationship between thepatient assembly and the patient's dentition is determined later in theprocess 850 such as by capturing images of the inside of the impressiondevice 200 after the patient assembly has been removed from the patient.

At operation 862, images are captured while the patient's mandiblemoves. In some embodiments, the patient's mandible is first moved in ahinge motion (e.g., opened straight up) one or more times. The patientmay move his or her jaw in accord with directions from the dentist.Additionally or alternatively, the dentist may move the patient's jaw.Based on the motion data captured by the patient, the location of thescrew axis of the temporomandibular joint may be determined.

In some embodiments, images are also captured while the patient'smandible is moved excursively and protrusively. Additionally, in someembodiments, images are captured while the patient engages in a chewingmotion such as by chewing on a bolus of wax or a similar substance. Inthis manner, images are captured throughout a range of patientmandibular movements.

At operation 864, the movement of the patient's mandible is determinedbased on the captured images. In some embodiments, the movement of thepatient's mandible is determined by analyzing the captured images todetermine the location of intersection points on screens in the images.Based on the determined locations of the intersection points, therelative positions and orientation of portions of the patient assemblycan be determined. Using the determined static relationship between thepatient assembly 104 and the patient's dentition the position andorientation of the patient's dentition can be determined in each of theimages (or sets of simultaneously captured images). Based on multipleimages, the motion of the patient's mandible relative to the maxilla canbe determined.

Alternatively, the movement of the patient's mandible is determinedbased on determining the location or orientation of one or more fiducialmarkers attached to the patient assembly.

At operation 866, a dental appliance is designed or a dental treatmentis planned based on digitally simulating the movement of the patient'smandible.

If desired, condyle displacement can be determined and analyzed duringpost processing by receiving or inferring the condyle locations relativeto the patient's dentition and applying the recorded motiontransformations to those condyle locations. These locations may bereceived via user input in a user interface. The user input may be basedon clinical physical measurements. These locations may also bedetermined by integrating three-dimensional images of at least a portionof the patient's craniofacial anatomy that includes the condyles withthe three-dimensional image of the patient's dentition.

The three-dimensional images of the patient's craniofacial anatomy mayinclude a combination of three-dimensional surface scans of thepatient's dentition, computed tomography (CT) data, cone beam computedtomography (CBCT) data, and three-dimensional photos. These threedimensional images of the patient's craniofacial anatomy may be alignedrelative to one another and the three-dimensional images of thepatient's dentition by matching common surfaces that are common tomultiple images. Additionally, the approximate condyle locations may beinferred based on the recorded motion when the jaw is opened and closed.

In some aspects, CBCT or CT data is captured while the patient iswearing a device that includes one or more fiducial markers. Forexample, the CBCT or CT data may be captured while the patient iswearing the impression device 200 (illustrated in FIG. 5) or the clutch462 (illustrated in FIG. 8). The CBCT or CT data can then be convertedto a mesh using an appropriate mesh creation algorithm such as themarching cubes algorithm. This mesh from the CBCT or CT data can then bealigned with a mesh representing an impression of the patient while thepatient is wearing the impression device 200. These two meshes can bealigned using various techniques such as an iterative closest pointalignment technique. Once aligned, the motion data captured while thepatient was wearing the impression device 200 can be applied to the meshof the CBCT or CT data. In this manner, the movement of the condyle canbe visualized in the condyle. The combined movement data and CBCT or CTdata can be used to, for example, plan implant treatments and evaluatevarious other types of restorations. In some embodiments, one an implantis positioned relative to the CBCT or CT data, the implant can move withthe CBCT or CT data.

Although the process 850 determines the static relationship between thepatient assembly and the patient's dentition before capturing imageswhile the patient's jaw in motion, other embodiments determine thestatic relationship at another point in time such as after capturingimages of the patient's jaw is in motion.

FIG. 17 is an example process 900 for determining the relative motion ofthe patient's upper and lower dentition based on images captured by theimaging system 102. In some embodiments, the process 900 is performed bythe motion determining device 106.

At operation 902, image sets of the patient assembly attached to apatient's dentition captured while the patient's dentition moves arereceived. In some embodiments, each of the image sets comprises a singleimage. In other embodiments, each of the image sets comprises multipleimages that were captured simultaneously (e.g., at the same orapproximately the same time) by different cameras.

At operation 904, a loop processes each of the received image sets.Within this description of the loop of operation 904, the received imageset that is being processed is referred to as the current image set.

At operation 906, the positions of the position indicators aredetermined by processing the images in the current image set. In someembodiments, image processing techniques are used to identify thelocation within the image of some or all of the fiducial markers. Thenbased on one or more of the position and size of the fiducial markerwithin the image, the three-dimensional position of the fiducial markeris determined. When an image set includes multiple images captured fromdifferent cameras disposed to captured images of the patient assemblyfrom a different angle, the positions of the fiducial markers in thedifferent images may be correlated to determine the position of threedimensional position of the fiducial marker.

Alternatively, the positions of the light beams on the screens (i.e.,the intersection points) are determined by processing the images in thecurrent image set. In some embodiments, image processing techniques areused to identify the location within the image of the intersectionpoint. In some embodiments, a color of the light beam is analyzed todetermine whether the light beam was emitted by the clutch or referencestructure.

At operation 908, the relative positions and orientations of the clutchand the reference structure are determined based on the positions of theposition indicators. As described previously, based on determining thethree-dimensional positions of multiple of the fiducial markers securedto each of the clutch and the reference structure, the positions andorientations of the clutch and the reference structure can bedetermined. Alternatively, based on determining the intersection pointsof the light beams with the screens, the relative position andorientation of the clutch relative to the reference structure can bedetermined.

At operation 910, the relative positions of the patient's upper andlower dentition based on the determined positions of the clutch andreference structure. In some embodiments, the relative positions aredetermined based on information about the static relationship betweenthe patient assembly and the patient's dentition.

At operation 912, it is determined whether there are more image sets toprocess through the loop. If so, the process 900 returns to operation906 to process the next image set. If not, the process continues tooperation 914.

At operation 914, the relative motion of the patient's upper and lowerdentition is determined based on the determined relative positions inthe image sets. In some embodiments, a series of transformation matrixesare generated that correspond to the relative movement of the patient'slower dentition relative to the upper dentition in each of the imagesets. This series of transformation matrixes can then be sequentiallyapplied to a digital model of the patient's lower dentition to cause thelower dentition to digitally move in accordance with the capturedmotion. In this manner, the motion data is used as a digitalarticulator.

At operation 916, the approximate location and motion of the screw axisis inferred using the determined relative motion. In some embodiments,at least a portion of the image sets are captured while the patient'smandible is moving in a hinge motion (i.e., simply opening and closingwithout any excursive or protrusive movement). These image sets may belabeled, stored separately, or otherwise distinguished from the otherimage sets. The motion data for the image sets corresponding to thishinge movement can be analyzed to determine the approximate location ofthe screw axis. For example, the motion data can be fit to a circulararc. The location of the center of the circular arc can then bedetermined. In some embodiments, it is then determined that the screwaxis passes through the center of the circle along a line that isorthogonal to the plane of the circular arc. Once the screw axis isinferred, the movement of the screw axis can be inferred as well. Therelative motion data for the mandible relative to the maxilla can beapplied to the screw axis to determine the movement of the screw axis.

FIG. 18 illustrates an example clutch 920 and an example transferassembly 922. The clutch 920 is example of a clutch such as the clutch462 shown in FIG. 8. The clutch 920 may include fiducial markers similarto the fiducial markers 466.

The transfer assembly 922 is usable to transfer coordinate informationto a physical articulator. The coordinate information may be digitallyderived based on the movement data and/or the inferred screw axislocation. For example, the transfer assembly 922 may be usable toposition the clutch 920 relative to a physical articulator in a positionthat allows the physical articulator to closely match the movementderived using the system 100.

The transfer assembly 922 includes a main body 924, sliding blocks 926a, 926 b, and pivot arms 928 a, 928 b. The main body 924 is usable toadjust the width of the transfer assembly 922. The main body 924 may bea horizontally aligned linear body. The main body 924 includes amounting assembly 930 and translation markings 932 a, 932 b. Themounting assembly 930 is usable to mount the clutch 920 to the transferassembly 922. In some embodiments, the mounting assembly 930 comprisesone or more apertures through which pins or keyed pins of the clutch 920can removably fit to mount the clutch 920 to the transfer assembly 922.Typically, the mounting assembly is configured to mount the clutch 920in a precise known relationship to the transfer assembly 922.

The translation markings 932 a, 932 b comprise a series of markings toindicate the width of the transfer assembly 922. In various embodiments,the translation markings 932 a, 932 b are disposed at differentlocations. For example, the translation markings 932 a, 932 b may eachinclude a plurality of markings at 1 mm intervals. Other distances arepossible too.

The sliding blocks 926 a, 926 b slide along the main body 924 to definethe width of the transfer assembly 922. In some embodiments, the slidingblocks 926 a, 926 b include locking assemblies 934 a, 934 b andalignment indicators 936 a, 936 b. Although alternatives are possible,the sliding blocks 926 a, 926 b typically move independently of eachother. In use, the sliding blocks 926 a, 926 b slide along the main body924 to a specified position, which can be determined with reference tothe translation markings 932 a, 932 b. In this manner, the slidingblocks 926 a, 926 b define the width of the transfer assembly 922. Insome embodiments, the sliding blocks 926 a, 926 b include lockingassemblies 934 a, 934 b to lock the sliding blocks 926 a, 926 b in aposition relative to the translation markings 932 a, 932 b. In someembodiments, the locking assemblies 934 a, 934 b comprise one or moreknobs or thumb screws.

The alignment indicators 936 a, 936 b are usable to indicate therotational position of the pivot arms 928 a, 928 b. In some embodiments,the alignment indicators 936 a, 936 b each comprise a single line tomark a place by which the rotation of the pivot arms 928 a, 928 b can becompared.

The pivot arms 928 a, 928 b rotate to adjust the position of thetransfer assembly 922. Although alternatives are possible, in thisexample, the pivot arms are rotatably connected to the sliding blocks926 a, 926 b. In some embodiments, the pivot arms 928 a, 928 b includeangle markings 938 a, 938 b, sliding blocks 940 a, 940 b, translationmarkings 942 a, 942 b, and locking assemblies 944 a, 944 b.

In this example, the angle markings 938 a, 938 b are disposed on arounded end of the pivot arm. The angle markings 938 a, 938 b rotatewith the pivot arm. The angle markings 938 a, 938 b can then be comparedto the alignment indicators 936 a, 936 b to determine the rotation ofthe pivot arms 928 a, 928 b relative to the sliding blocks 926 a, 926 b(and therefore to the main body 924). Once the pivot arms 928 a, 928 bare rotated to a specified position, the locking assemblies 944 a, 944 bcan be used to lock the rotation of the pivot arms 928 a, 928 b. Thelocking assemblies 944 a, 944 b may be similar to the locking assemblies934 a, 934 b.

The sliding blocks 940 a, 940 b slide along the pivot arms 928 a, 928 bto adjust the depth of the transfer assembly 922. As mentioned above,the pivot arms 928 a, 928 b include translation markings 942 a, 942 b,which can be used as a reference in aligning the sliding blocks 940 a,940 b at a specified distance from the main body 924. The translationmarkings 942 a, 942 b may be similar to the translation markings 932 a,932 b.

In some embodiments, the sliding blocks 940 a, 940 b include articulatorcouplers 946 a, 946 b and locking assemblies 948 a, 948 b. Thearticulator couplers 946 a, 946 b are configured to mate with a featureof a target articulator. Depending on the target articulator, thearticulator couplers 946 a, 946 b will have different forms.

The locking assemblies 948 a, 948 b are configured to lock the slidingblocks 940 a, 940 b at a specified position along the pivot arms 928 a,928 b. The locking assemblies 948 a, 948 b may be similar to the lockingassemblies 934 a, 934 b.

In some embodiments, the motion determining device 106 or anothercomponent of the system 100 determines parameters for the transferassembly 922. Examples parameters include the positions of the slidingblocks 926 a, 926 b relative to the translation markings 932 a, 932 b;the rotation of the pivot arms 928 a, 928 b relative to the slidingblocks 926 a, 926 b, which can be evaluated with reference to the anglemarkings 938 a, 938 b and the alignment indicators 936 a, 936 b; and thepositions of the sliding blocks 940 a, 940 b relative to the translationmarkings 942 a, 942 b. These parameter settings can be displayed on adisplay device of a computing device, printed on a report, or otherwisecommunicated to a user. The user can then adjust the transfer assembly922 to match the specified settings. Once setup, the transfer assemblycan be used to mount a stone model of the upper dentition to anarticulator at the position associated with the specified settings. Astone model of the lower dentition can then be mounted relative to thestone model of the upper dentition (e.g., using a bite record). In thismanner, the transfer assembly 922 can be used to mount stone models ofthe dentition on an articulator so as to best match the movement datacaptured using the system 100.

In some embodiments of the transfer assembly 922, some or all of thetranslation markings 932 a, 932 b, 942 a, 942 b and angular markings 938a, 938 b are replaced with digital readouts that are based on linearand/or rotary encoders.

FIG. 19 illustrates a calibration assembly 1040 that is usable withembodiments of the system of FIG. 1. The calibration assembly 1040 isused to calibrate the image coordinates of images captured by theimaging system 102 to real-world coordinates on the screens 438. Oncethe system 100 has been calibrated, the pixels in the images captured bythe cameras 420 can be mapped to real-world coordinates on the screens438. For example, the real-world coordinates of the intersection pointson the screens 438 of the light beams emitted by the light sourceassembly 404 can be determined based on the pixel of the images thatincludes the light beam.

In some embodiments, the calibration assembly 1040 is configured toattach to the screen framework 436. After the calibration assembly 1040is attached, a calibration image is captured by at least one of thecameras 420. The calibration assembly 1040 includes a calibration region1044. In some embodiments, the calibration region 1044 includes aplurality of markings 1046 disposed at known positions. In this example,the calibration region 1044 includes four rows of six markings 1046.Other embodiments include different numbers of and arrangements ofmarkings 1046. For example, some embodiments include ten rows ofthirteen markings 1046. In some embodiments, the calibration region 1044is sized to cover the portion of the screen in which light beams areexpected to intersect.

In some embodiments, the markings 1046 are configured to be identifiablein images of the calibration assembly 1040. Although alternatives arepossible, in this example, the markings 1046 are dots that contrast withthe rest of the calibration region 1044. For example, the markings 1046can be black over a white background. The markings 1046 have knowndimensions and positions. For example, in some embodiments the markings1046 are round circles having a known diameter (e.g., five millimeters)and known spacing (e.g., spaced apart by twenty millimeters). In someembodiments, the positions are known relative to each other. In someembodiments, the positions are known relative to the screen framework436 when the calibration assembly 1040 is attached. In some embodiments,the markings 1046 include raised or indented portions. In theembodiments, a coordinate measurement system can identify the markings1046 and measure the locations of the markings 1046.

In some embodiments, image processing techniques are used to determinethe pixel coordinates of the centers of the markings 1046 in acalibration image captured by one of the cameras 420. For example, acircle can be best fit to each of the contrasting regions in the image.The pixel corresponding to the center point of each of the circles canthen be determined. In some embodiments, a map is then built to map fromthe determined center points to real-world positions based on the knowninformation about the calibration markings.

In some embodiments, the calibration region 1044 includes calibrationmarkings that are lines that form a grid pattern or squares that form acheckerboard pattern. Other arrangements of the calibration region arepossible as well.

The calibration assembly 1040 also includes an attachment assembly 1042.The attachment assembly 1042 is a physical structure that is configuredto removably couple the calibration assembly 1040 to the screenframework 436. In this example, the attachment assembly 1042 includes aplurality of apertures through which fasteners can be used to attach thecalibration assembly 1040 to the screen framework 436. Examples offasteners include bolts, such as shoulder bolts, and screws. In someembodiments, the screen framework 436 includes registration structures(e.g., pegs) that are configured to mate with the attachment assembly1042 to attach the calibration assembly 1042 to the screen framework436. In at least some embodiments, the calibration region 1044 isdisposed at a known distance from an edge or other landmark of thecalibration assembly 1040. In this manner, when the calibration assembly1040 is registered to the screen framework 436, the position of thecalibration region 1044 (and the markings 1046 therein) can bedetermined relative to the screen framework 436.

In some embodiments, the screens 438 are configured to be removed fromthe screen framework 436 by a user (e.g., the screens 438 can alsoinclude attachment assemblies that are similar to the attachmentassembly 1042. In some embodiments, the screens 438 are removed from thescreen framework 436 and replaced by the calibration assembly 1040during a calibration process. In some embodiments, the calibrationassembly 1040 is attached to the screen framework 436 between thecameras 420 and the screens 438. In some embodiments, the calibrationassembly 1040 is attached to the screen framework 436 so that one of thescreens 438 is disposed between the calibration assembly 1040 and thecamera 420. In these embodiments, the calibration images of thecalibration assembly 1040 are captured through the screens 438.

FIG. 20 illustrates an example embodiment of a dentition coupling device1080 such as the dentition coupling device 124 or the dentition couplingdevice 130.

The dentition coupling device 1080 couples to a patient's dentition. Insome embodiments, the dentition coupling device 1080 includes theextension member 182, an arch portion 1082, a plurality of apertures1084 a, 1084 b, 1084 c, and 1084 d, a adjustable block 1086, and afastener 1088. The extension member 182 is described above.

The arch portion 1082 is shaped to approximate the dental arch of apatient and is sized to fit around the outside of the patient'sdentition. For example, in some embodiments, the arch portion 1082 issized to fit around the buccal surfaces of at least a portion of thepatient's dentition. The arch portion includes plurality of recessesthat include the apertures 1084 a, 1084 b, 1084 c, 1084 d. In thisexample, there are four recesses, each having one aperture. However,other embodiments include different numbers of recesses and/orapertures.

At least some of the recesses include an adjustable block such as theadjustable block 1086. Although only one adjustable block is shown inthis figure, some embodiments include more than one adjustable block.For example, in some embodiments, there is one adjustable block for eachrecess. The position of the adjustable block 1086 can be adjustedrelative to the arch portion 1082 so that a surface of the adjustableblock 1086 contacts the buccal or labial surfaces of a portion of thepatient's dentition. In some embodiments, the adjustable block issecured in contact with the patient's dentition using fastener 1088. Theadjustable block 1086 may include an slot that receives the fastener1088 and allows for sliding movement of the adjustable block 1086 untilthe fastener is fully engaged. In some embodiments, the adjustableblocks are positioned and then adhered to the patient's dentition usingan adhesive material such as a light-cured bonding agent. In thismanner, the dentition coupling device 1080 can be coupled to thepatient's dentition. Beneficially, the dentition coupling device 1080can be reused with multiple patients after sufficient cleaning andsterilization.

FIG. 21 illustrates an example architecture of a computing device 950that can be used to implement aspects of the present disclosure,including any of the plurality of computing devices described herein,such as a computing device of the motion determining device 106, thedesign system 816, or any other computing devices that may be utilizedin the various possible embodiments.

The computing device illustrated in FIG. 21 can be used to execute theoperating system, application programs, and software modules describedherein.

The computing device 950 includes, in some embodiments, at least oneprocessing device 960, such as a central processing unit (CPU). Avariety of processing devices are available from a variety ofmanufacturers, for example, Intel or Advanced Micro Devices. In thisexample, the computing device 950 also includes a system memory 962, anda system bus 964 that couples various system components including thesystem memory 962 to the processing device 960. The system bus 964 isone of any number of types of bus structures including a memory bus, ormemory controller; a peripheral bus; and a local bus using any of avariety of bus architectures.

Examples of computing devices suitable for the computing device 950include a desktop computer, a laptop computer, a tablet computer, amobile computing device (such as a smart phone, an iPod® or iPad® mobiledigital device, or other mobile devices), or other devices configured toprocess digital instructions.

The system memory 962 includes read only memory 966 and random accessmemory 968. A basic input/output system 970 containing the basicroutines that act to transfer information within computing device 950,such as during start up, is typically stored in the read only memory966.

The computing device 950 also includes a secondary storage device 972 insome embodiments, such as a hard disk drive, for storing digital data.The secondary storage device 972 is connected to the system bus 964 by asecondary storage interface 974. The secondary storage devices 972 andtheir associated computer readable media provide nonvolatile storage ofcomputer readable instructions (including application programs andprogram modules), data structures, and other data for the computingdevice 950.

Although the example environment described herein employs a hard diskdrive as a secondary storage device, other types of computer readablestorage media are used in other embodiments. Examples of these othertypes of computer readable storage media include magnetic cassettes,flash memory cards, digital video disks, Bernoulli cartridges, compactdisc read only memories, digital versatile disk read only memories,random access memories, or read only memories. Some embodiments includenon-transitory computer-readable media. Additionally, such computerreadable storage media can include local storage or cloud-based storage.

A number of program modules can be stored in secondary storage device972 or system memory 962, including an operating system 976, one or moreapplication programs 978, other program modules 980 (such as thesoftware engines described herein), and program data 982. The computingdevice 950 can utilize any suitable operating system, such as MicrosoftWindows™, Google Chrome™ OS or Android, Apple OS, Unix, or Linux andvariants and any other operating system suitable for a computing device.Other examples can include Microsoft, Google, or Apple operatingsystems, or any other suitable operating system used in tablet computingdevices.

In some embodiments, a user provides inputs to the computing device 950through one or more input devices 984. Examples of input devices 984include a keyboard 986, mouse 988, microphone 990, and touch sensor 992(such as a touchpad or touch sensitive display). Other embodimentsinclude other input devices 984. The input devices are often connectedto the processing device 960 through an input/output interface 994 thatis coupled to the system bus 964. These input devices 984 can beconnected by any number of input/output interfaces, such as a parallelport, serial port, game port, or a universal serial bus. Wirelesscommunication between input devices and the interface 994 is possible aswell, and includes infrared, BLUETOOTH® wireless technology,802.11a/b/g/n, cellular, ultra-wideband (UWB), ZigBee, or other radiofrequency communication systems in some possible embodiments.

In this example embodiment, a display device 996, such as a monitor,liquid crystal display device, projector, or touch sensitive displaydevice, is also connected to the system bus 964 via an interface, suchas a video adapter 998. In addition to the display device 996, thecomputing device 950 can include various other peripheral devices (notshown), such as speakers or a printer.

When used in a local area networking environment or a wide areanetworking environment (such as the Internet), the computing device 950is typically connected to the network through a network interface 1000,such as an Ethernet interface or WiFi interface. Other possibleembodiments use other communication devices. For example, someembodiments of the computing device 950 include a modem forcommunicating across the network.

The computing device 950 typically includes at least some form ofcomputer readable media. Computer readable media includes any availablemedia that can be accessed by the computing device 950. By way ofexample, computer readable media include computer readable storage mediaand computer readable communication media.

Computer readable storage media includes volatile and nonvolatile,removable and non-removable media implemented in any device configuredto store information such as computer readable instructions, datastructures, program modules or other data. Computer readable storagemedia includes, but is not limited to, random access memory, read onlymemory, electrically erasable programmable read only memory, flashmemory or other memory technology, compact disc read only memory,digital versatile disks or other optical storage, magnetic cassettes,magnetic tape, magnetic disk storage or other magnetic storage devices,or any other medium that can be used to store the desired informationand that can be accessed by the computing device 950.

Computer readable communication media typically embodies computerreadable instructions, data structures, program modules or other data ina modulated data signal such as a carrier wave or other transportmechanism and includes any information delivery media. The term“modulated data signal” refers to a signal that has one or more of itscharacteristics set or changed in such a manner as to encode informationin the signal. By way of example, computer readable communication mediaincludes wired media such as a wired network or direct-wired connection,and wireless media such as acoustic, radio frequency, infrared, andother wireless media. Combinations of any of the above are also includedwithin the scope of computer readable media.

The computing device illustrated in FIG. 21 is also an example ofprogrammable electronics, which may include one or more such computingdevices, and when multiple computing devices are included, suchcomputing devices can be coupled together with a suitable datacommunication network so as to collectively perform the variousfunctions, methods, or operations disclosed herein.

In a non-limiting example, a clutch is attached to an emitter thatprojects three laser beams. Two of the laser beams are co-linear andproject in opposite directions. The third laser beam is perpendicular tothe first two laser beams. All three laser beams are co-planar. Aclutch-emitter assembly is attached to each arch. The emitters projectlaser dots onto three translucent screens such that one upper arch andone lower arch laser dot appears on each screen. Each screen is viewedby a separate video camera. The cameras are synchronized such that theycapture frames simultaneously or nearly simultaneously. In someembodiments, the cameras include a synchronization input port and thesystem includes a synchronization system that is configured tosimultaneously transmit a signal to the synchronization input port ofeach of the cameras, causing the cameras to begin to capture videosynchronously.

In some embodiments, variations in the alignment of the screens to eachother and the cameras is compensated for in software. Camerafield-of-view distortion is also compensated for in software. The upperarch dot is distinguished from the lower arch dot on each screen usingone or more of the following techniques: upper arch dots are assumed tobe those highest on the screens and lower arch dots are assumed to bethose lowest on the screens; upper arch dots are projected in one colorand lower arch dots are projected in a different color; and dots arepulsed such that upper arch dots are projected and imaged after whichlower arch dots are projected and imaged.

The various embodiments described above are provided by way ofillustration only and should not be construed to limit the claimsattached hereto. Those skilled in the art will readily recognize variousmodifications and changes that may be made without following the exampleembodiments and applications illustrated and described herein, andwithout departing from the true spirit and scope of the followingclaims.

What is claimed is:
 1. An apparatus comprising: a screen; an imagingsystem configured to capture an image of the screen; a dentitioncoupling device configured to couple to an arch of a patient'sdentition, the dentition coupling device including an extension memberconfigured to protrude out from the patient's mouth; and a positionindicating system rigidly connected to the dentition coupling device,the position indicating system including: a housing configured torigidly connect to the extension member of the dentition couplingdevice; a first light emitter disposed within the housing and orientedto emit light in a first direction toward the screen; a second lightemitter disposed within the housing and oriented to emit light in asecond direction, the second direction being collinear with and oppositeto the first direction; and a third light emitter disposed within thehousing and oriented to emit light in a third direction, the thirddirection being different than the first direction and the seconddirection; a reference dentition coupling device configured to couple toan arch of the patient's dentition opposite of the dentition couplingdevice, the reference dentition coupling device including an extensionmember configured to protrude out from the patient's mouth; and areference position indicating system rigidly connected to the referencedentition coupling device, the reference position indicating systemincluding a reference light emitter configured to emit light toward thescreen.
 2. The apparatus of claim 1, wherein the third light emitter isoriented so that a line corresponding to the third direction intersectswith a line corresponding to the first direction.
 3. The apparatus ofclaim 2, wherein the third light emitter is oriented so that the thirddirection is perpendicular to the first direction.
 4. A patient assemblyfor capturing motion data of a patient comprising: a screen; an imagingsystem configured to capture an image of the screen; a clutch configuredto be worn by the patient on the patient's dentition, the clutchcomprising: a dentition coupling device configured to couple to an archof the dentition of the patient, the dentition coupling device includingan extension member configured to protrude out from the patient's mouth;a housing configured to rigidly connect to the extension member of thedentition coupling device; a first light emitter disposed within thehousing and oriented to emit light in a first direction; a second lightemitter disposed within the housing and oriented to emit light in asecond direction, the second direction being collinear with and oppositeto the first direction; and a third light emitter disposed within thehousing and oriented to emit light in a third direction, the third lightemitter oriented such that a line corresponding to the third directionintersects a line corresponding to the first direction; and a referenceclutch configured to be worn by the patient on the patient's dentition,the reference clutch comprising: a reference dentition coupling deviceconfigured to couple to an arch of the dentition of the patient oppositethe dentition coupling device of the clutch, the reference dentitioncoupling device including an extension member configured to protrude outfrom the patient's mouth; a reference housing configured to rigidlyconnect to the extension member of the reference dentition couplingdevice; a first reference light emitter disposed within the referencehousing and oriented to emit light in a first reference direction; asecond reference light emitter disposed within the reference housing andoriented to emit light in a second reference direction, the secondreference direction being collinear with and opposite to the firstreference direction; and a third reference light emitter disposed withinthe reference housing and oriented to emit light in a third referencedirection, the third reference light emitter oriented such that a linecorresponding to the third reference direction intersects a linecorresponding to the first reference direction, wherein the first lightemitter is configured to emit light in a first direction toward thescreen and the first reference light emitter is configured to emit lightin a first reference direction toward the screen, wherein the screen isdisposed between the imaging system and the clutch.
 5. The patientassembly of claim 4, wherein the first light emitter, the second lightemitter, and the third light emitter are configured to emit light byalternating between an on phase and an off phase, and the firstreference light emitter, the second reference light emitter, and thethird reference light emitter are configured to emit light byalternating between a reference on phase and a reference off phase, theon phase and the reference on phase being out of phase.
 6. The apparatusof claim 1, wherein the dentition coupling device comprises animpression device comprising an inner surface that forms a trough forimpression material.
 7. The patient assembly of claim 4, wherein thefirst light emitter, the second light emitter, and the third lightemitter are configured to emit light having a first color and the firstreference light emitter, the second reference light emitter, and thethird reference light emitter are configured to emit light having asecond color, wherein the first color and the second color aredifferent.
 8. The patient assembly of claim 4, wherein the first lightemitter emits substantially collimated light, the second light emitteremits substantially collimated light, and the third light emitter emitssubstantially collimated light.
 9. The patient assembly of claim 8,wherein the first light emitter, the second light emitter, and the thirdlight emitter emit laser beams.
 10. The patient assembly of claim 9,wherein the first light emitter includes a first laser diode, the secondlight emitter includes a second laser diode, and the third light emitterincludes a third laser diode.
 11. The patient assembly of claim 8,wherein the first light emitter is a first aperture of a beam splitterassembly, the second light emitter is a second aperture of the beamsplitter assembly, and the third light emitter is a third aperture ofthe beam splitter assembly.
 12. The patient assembly of claim 4, whereinthe housing is removably connected to the dentition coupling device. 13.The patient assembly of claim 12, further comprising a registrationstructure that causes the housing to connect to the dentition couplingdevice in a repeatable position and orientation.
 14. The patientassembly of claim 12, further comprising a magnetic clasp for removablycoupling the housing to the dentition coupling device.
 15. The patientassembly of claim 4, wherein the dentition coupling device furthercomprises a plurality of internal fiducial markers, the internalfiducial markers being usable to determine a static relationship betweenthe dentition coupling device and the dentition of the patient.
 16. Amotion capture system for capturing jaw movement of a patient, thesystem comprising: a patient assembly configured to be worn by thepatient, the patient assembly comprising a clutch configured to be wornon an arch of the patient's dentition and a reference structureconfigured to be worn on the opposite arch, the reference structurebeing configured to emit a plurality of reference light beams and theclutch including: a dentition coupling device configured to couple tothe dentition of the patient, the dentition coupling device including anextension member configured to protrude out from the patient's mouth;and a position indicating system rigidly connected to the dentitioncoupling device, the position indicating system including: a housingconfigured to rigidly connect to the extension member of the dentitioncoupling device; a first light emitter disposed within the housing andoriented to emit light in a first direction; a second light emitterdisposed within the housing and oriented to emit light in a seconddirection, the second direction being collinear with and opposite to thefirst direction; and a third light emitter disposed within the housingand oriented to emit light in a third direction, the third directionbeing different than the first direction and the second direction; animaging system configured to capture a plurality of image sets, whereineach image set comprises a plurality of images and each image of theplurality of images includes at least one of a plurality of screensdisposed between the imaging system and the patient assembly; and amotion determining device configured to process image sets captured bythe imaging system to determine the motion of the patient's dentition.17. The motion capture system of claim 16, wherein the motiondetermining device is further configured to infer an approximatelocation of a screw axis of the patient using the determined motion ofthe patient's dentition.
 18. The motion capture system of claim 16,wherein the imaging system comprises: a framework that is connected tothe screens, wherein the framework is configured to dispose each of theplurality of screens to intersect with at least one of the plurality ofthe light beams when the patient assembly is being worn by the patient;and a plurality of cameras, each of the plurality of cameras beingrigidly coupled to the framework and being oriented to capture images ofone of the plurality of screens.
 19. The motion capture system of claim18, wherein the plurality of screens includes three screens and theplurality of cameras includes three cameras.
 20. The motion capturesystem of claim 18, wherein the screens are removably connected to theframework and the motion capture system further comprises a calibrationassembly that is configured to removably attach to the framework inplace of a screen from the plurality of screens, the calibrationassembly including a calibration region having a plurality ofcalibration markings.